Journal article
Heterogeneity in the uptake, attendance and outcomes in a clinical trial of a total diet replacement weight loss programme
- Abstract:
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Background: Trials have shown total diet replacement programmes (TDR) are safe and effective for weight loss in primary care. However, it is not clear whether participant characteristics affect uptake, attendance or effectiveness of the programme.
Methods: We used data from 272 trial participants who were invited to participate in a clinical weight loss trial via a letter from their GP. We used a Cochran-Mantel-Haenszel analysis to assess whether accepting an invitation to participate in the trial differed by gender, age, BMI, social deprivation, and the presence of a diagnosis of type 2 diabetes or hypertension. We used mixed generalised linear modelling to examine whether participants’ age, gender, or social deprivation based on area of residence were associated with weight change at 12 months.
Results: Men were less likely to enrol than women (RR 0.59 [95% CI 0.47, 0.74]) and people from the middle and highest BMI tertile were more likely to enrol than those from the lowest tertile (RR 2.88 [95%CI 1.97, 4.22] and RR 4.38 [95% CI 3.05, 6.07] respectively). Patients from practices located in most deprived and intermediate deprived tertiles were more likely to enrol compared with those in the least deprived tertile (RR 1.84 [95% CI 1.81, 2.59]] and (RR 1.68 [95% CI 1.18, 2.85] respectively). There was no evidence that age or a pre-existing diagnosis of type 2 diabetes (RR 1.10 [95% CI 0.81, 1.50]) or hypertension (RR 0.81 [95% CI [0.62, 1.04]) affected enrolment. In the TDR group 13% of participants were low engagers, 8% engaged with the weight loss phase only and 79% engaged in both weight loss and weight maintenance phases of the programme. Those who engaged in the entire programme lost most weight. Subgroup analyses suggested that olderparticipants and those with a higher baseline BMI lost more weight at 1 year than their comparators.
Conclusion: Despite some heterogeneity in the uptake and outcomes of the programme, if the results of this trial are replicated in routine practice, there is no evidence that TDR weight loss programmes would increase inequity.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 953.3KB, Terms of use)
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- Publisher copy:
- 10.1186/s12916-020-01547-4
Authors
- Publisher:
- BMC
- Journal:
- BMC Medicine More from this journal
- Volume:
- 18
- Issue:
- 2020
- Article number:
- 86
- Publication date:
- 2020-04-16
- Acceptance date:
- 2020-03-03
- DOI:
- ISSN:
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1741-7015
- Language:
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English
- Keywords:
- Pubs id:
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1090786
- Local pid:
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pubs:1090786
- Deposit date:
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2020-03-03
Terms of use
- Copyright holder:
- Astbury et al.
- Copyright date:
- 2020
- Rights statement:
- © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data
- Licence:
- CC Attribution (CC BY)
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